St. Joe’s Workshop is the website of the re-employment ministry at St. Anastasia Roman Catholic Church in Troy, Michigan. The ministry is an effort to help those who are in need of work. Information to help your job search includes: prayers and Christian reflections, job listings, educational opportunities, financial management resources, and job search tips.

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4571 John R Rd
Troy, MI 48085
248-689-8380

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Appeals Analyst

by KHouseman on April 25, 2013

Ready to join our dynamic team? Come and excel with our talented people. We strive to be the best by demanding and delivering excellence; by providing our employees challenging, rewarding work and opportunities for personal and professional growth. To apply for this position, email Colleen Schmerheim at hr@advomas.com

Great Company/Great Benefits/Great People/ Great Mission!

Summary: The Appeals Analyst is responsible for reviewing and processing patient appeals within Federal,

State and organizational regulations for Medicaid.

Responsibilities: Researches laws, regulations, policies and precedent decisions to prepare for appeal hearings.

Files necessary documentation to the Department of Human Services on behalf of patient.

Determine what and which parties should be approached to obtain additional or

missing information/documentation necessary to make a determination for Medicaid.

Collaborate with experts within the organization to obtain benefit and/or

opinions/interpretations of complex cases.

Correspond with patient and state program providers regarding appeals decision.

Represent patients at Department of Human Services administrative hearings.

Maintains monthly logs and reports and provide to the Director of Appeals on a monthly basis.

Must be able to work and communicate with diverse groups of people, clients, and agencies.

All other duties as assigned.

Competencies: To perform this job successfully an individual should be able to synthesize complex or diverse information, identify and resolve problems in a timely manner, and react well under pressure. The successful candidate will have strong work ethic, a positive team spirit, professional /compassionate demeanor and a passion for helping those in need!

Qualifications: Bachelor’s degree from a four year college or university; or one to two years related experience and/or training; or equivalent combination of education and experience. Must have a minimum of 3 years experience at the Department of Human Services or 3-5 years experience with evaluating disability claims. A solid knowledge of Microsoft Excel, Word Processing, and Outlook software. Ability to read, analyze, and interpret complex documents.

Certificates, Licenses, Registrations: Must have and maintain a valid driver’s license

Other Skills and Abilities: Knowledge of Medicaid programs and policies. Knowledge of program appeal time frames and deadlines. Must be able to articulate case fact in a thorough & professional manner. Ability to determine type of appeal. Ability to review case file for potential resources and other payer sources. Must be able to pass a drug screen and background check.

With Advomas, you will be on the road to exciting professional challenges and opportunities. You will find that we offer competitive salaries, excellent benefits, and a rewarding environment. To submit a resume, fax/email to:

HR@Advomas.com

Fax: 248-989-4201

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